Giving voice: an oral history of speech and language therapy.

BACKGROUND: The Royal College of Speech and Language Therapists (RCSLT) celebrates its 75th anniversary in 2020. The historical study of speech and language therapy (SLT) has been very limited. A small number of publications have traced the changes in the profession over time, but to date there has been no comprehensive work undertaken to gain an insight into the experiences of UK speech therapists who entered the newly formed profession after 1945. AIMS: To use an oral history methodology to explore the life stories of early members of the profession. METHODS & PROCEDURES: Participants were recruited through RCSLT networks. Interviews were held across England and Scotland. Conversations were audio recorded and analysed using thematic network analysis. Archive material was used to complement participants' narratives. OUTCOMES & RESULTS: Participants were 19 women who qualified between 1945 and 1968. Three global themes emerged: personal, professional and political stories. On a personal level, each reported steps towards autonomy and agency within the social constraints they experienced. Professionally, all commented on the vast expansion in the range of identifiable clinical fields between 1945, when the first participant qualified, and 2008, when the last participant retired. Politics and social policies impacted upon their lives and, sometimes to their surprise, the participants found themselves campaigning politically in pursuit of fairness for their profession. CONCLUSIONS & IMPLICATIONS: This paper offers a unique insight into the challenges and achievements participants experienced over their careers as early practitioners in the UK profession.

Content analysis of the professional journal of the Royal College of Speech and Language Therapists, III: 1966-2015-into the 21st century.

BACKGROUND: Following content analyses of the first 30 years of the UK speech and language therapy professional body's journal, this study was conducted to survey the published work of the speech (and language) therapy profession over the last 50 years and trace key changes and themes. AIM: To understand better the development of the UK speech and language therapy profession over the last 50 years. METHODS & PROCEDURES: All volumes of the professional journal of the Royal College of Speech and Language Therapists published between 1966 and 2015 (British Journal of Communication Disorders, European Journal of Communication Disorders and International Journal of Language and Communication Disorders) were examined using content analysis. The content was compared with that of the same journal as it appeared from 1935 to 1965. OUTCOMES & RESULTS: The journal has shown a trend towards more multi-authored and international papers, and a formalization of research methodologies. The volume of papers has increased considerably. Topic areas have expanded, but retain many of the areas of study found in earlier issues of the journal. CONCLUSIONS & IMPLICATIONS: The journal and its articles reflect the growing complexity of conditions being researched by speech and language therapists and their professional colleagues and give an indication of the developing evidence base for intervention and the diverse routes which speech and language therapy practice has taken over the last 50 years.

From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences.

The development of rehabilitation has traditionally focused on measurements of motor disorders and measurements of the improvements produced during the therapeutic process; however, physical rehabilitation sciences have not focused on understanding the philosophical and scientific principles in clinical intervention and how they are interrelated. The main aim of this paper is to explain the foundation stones of the disciplines of physical therapy, occupational therapy, and speech/language therapy in recovery from motor disorder. To reach our goals, the mechanistic view and how it is integrated into physical rehabilitation will first be explained. Next, a classification into mechanistic therapy based on an old version (automaton model) and a technological version (cyborg model) will be shown. Then, it will be shown how physical rehabilitation sciences found a new perspective in motor recovery, which is based on functionalism, during the cognitive revolution in the 1960s. Through this cognitive theory, physical rehabilitation incorporated into motor recovery of those therapeutic strategies that solicit the activation of the brain and/or symbolic processing; aspects that were not taken into account in mechanistic therapy. In addition, a classification into functionalist rehabilitation based on a computational therapy and a brain therapy will be shown. At the end of the article, the methodological principles in physical rehabilitation sciences will be explained. It will allow us to go deeper into the differences and similarities between therapeutic mechanism and therapeutic functionalism.

[Lublin - the capital of polish speech and language therapy. Half a century of slt education in UMCS].

Lublin is the capital of Polish speech and language therapy (SLT) and this fact is justified by both historical as well as support in evaluating the potential of science - research and teaching, particularly in connection with the activities of the Department of Logopedics/SLT and Applied Linguistics of University of Maria Curie-Sklodowska and Polish Logopedic Society. The article discusses the history of the formation of SLT in Poland, strongly associated with Lublin, and also presents Lublin SLT educational traditions and the current teaching and research activities of the Department of Logopedics/SLT and Applied Linguistics of UMCS.

Rehabilitation of aphasia.

Aphasia is one of the most striking cognitive sequels of strokes and other cerebral lesions, and attempts to rehabilitate aphasic patients have been undertaken for many years. Following a brief overview of the epidemiology and the clinical characteristics of aphasia, the chapter presents the major traditional approaches to rehabilitation. They include the stimulation approach (also called classic), the behavior modification approach, Luria's approach (functional reorganization), the pragmatic approach, as well as the neurolinguistic approach. The next section illustrates some of the current approaches to aphasia rehabilitation, specifically the syndromic approach (also called neoassociationist), the cognitive neuropsychological approach, and the social approach. The chapter then provides examples of specific methods. While all intervention strategies may be classified, more or less correctly, into one or another of the above categories, it is not possible to mention the hundreds of specific interventions to be found in the literature, some of which have been described only briefly and in reference to a single case. The chapter concludes with a review of efficacy studies on aphasia therapy. Despite some opinions to the contrary, the current consensus is that sufficient experimental evidence of efficacy exists to recommend treatment of aphasia.

Historical and cultural influences on establishing professional legitimacy: a case example from Lionel Logue.

PURPOSE: In the film The King's Speech, the credibility of the king's speech clinician, Lionel Logue, is challenged. This article examines Logue's credentials in light of the credentialing standards and attitudes of Logue's time as well as those affecting today's practices. The aim is to show how standards of legitimacy change with the times. METHOD: Documents related to clinical qualifications and clinical practices are analyzed for the period in the early 20th century, when Logue practiced. They are then compared with how clinicians of today attain professional legitimacy. CONCLUSION: Early 20th century clinicians drew their credibility from their home disciplines such as medicine, phonetics, elocution, and education. Some of their therapies originated in the home discipline. Other therapies were commonly used, regardless of one's disciplinary background. Lionel Logue's background and methods would not have been suspect in his time. He may have been faulted by some for his lack of scientific perspective, but another likely source for the challenges to his credibility were early 20th century British social biases against Australians and against those using Australian dialects. The comparative analysis revealed that early 20th century clinicians and clinicians of today have certain clinical practices in common, but they differ considerably in how they establish their legitimacy. This indicates that judgments about a clinician's legitimacy are both historically and culturally determined.

The "Iowa Way" revisited.

UNLABELLED: This paper attempts to bridge the gap between past and present stuttering therapy approaches. Specifically, the ideas and methods of Wendell Johnson and Dean Williams are compared to current approaches used in treating mental illness and communication disorders in which there is an emphasis on focusing on what is "right" with the individual and spending less time focusing on the "disorder". There is particular emphasis on tying Johnson's and Williams' overall philosophy to modern psychological approaches rooted in "Positive Psychology", to highlight how these early ideas in stuttering therapy may help us to discover the common factors that underlie the success of several different stuttering therapy approaches, independent of the specific techniques employed. It is proposed that future research on clinical efficacy in stuttering should use focused hypotheses techniques to investigate common factors that make therapy effective across individuals and therapy approaches. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the basic philosophy of the "Iowa" approach to stuttering as laid out by Wendell Johnson and Dean Williams; (2) describe current therapeutic techniques that incorporate "positive psychology"; (3) discuss possible common factors that influence therapy outcome that are independent of the therapeutic technique employed.

A dialogue among various cultures and its manifestation in stuttering therapy.

UNLABELLED: This paper presents a historical retrospective of the evolution of the clinical aspects of stuttering, and refers to social, cultural, political, and economic variables that might have exerted an influence on this evolution, particularly in relation to the authors' experience in Israel. The retrospective commences in the early decades of the 20th century, when speech and language pathology did not exist as a profession, and presents the major approaches to therapy in children and adults employed by clinicians throughout the century. We focused on the impact of the change that occurred in religious society vis-à-vis stuttering on the various aspects of stuttering therapy and research. The Israeli Stuttering Organization - AMBI - is discussed in order to explore the possible influence of social, cultural, and political variables. In addition, we devoted special attention to the changes that occurred in the therapist-client relationship since they are indicative of the change in the nature of the treatment. We elaborated on the need for dialogue as a major component in the therapy and as an important contributor to a successful outcome. The dialogue is also discussed in terms of Eastern philosophy. Future developments in the understanding of stuttering and its implications for therapy are presented and discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize the history of the clinical development of stuttering and explore the possible influence of social, cultural, political, and economic variables particularly in relation to Israel; (2) provide a new definition of stuttering; and (3) contrast the model of a dialogue as opposed to a monologue and explain its use in the therapist-client relationship.

[Hinko Lehner--the first Croatian logoped]. / Hinko Lehner--prvi hrvatski logoped.

In his career, somewhat longer than 22 years, Lehner was frequently transferred from place to place. Beside working as municipal and county physician he worked also as a spa doctor. Very much interested in the stuttering treatment, his own problem that he had solved during his student period in Vienna, he kept trying to sensitize his fellow-doctors, teachers, but also the Croatian authorities for this problem. He lectured and published on this topic in the professional medical journal, but also in the newspapers. About stuttering he published, at his own expenses, first a booklet (1895) and then a book (1912). Therefore it is justified to consider him a pioneer of logopedy in Croatia albeit, regrettably, forgotten. In order to improve the health situation in Croatia as well as the social status of his profession, he wrote about the health system and the position of doctor in the society.

Training everyday communication partners for individuals with traumatic brain injury: the influence of Mark Ylvisaker.

This lead article outlines some of the seminal concepts introduced by Mark Ylvisaker in collaboration with his colleague Tim Feeney and describes the influence of this work on the development of an everyday communication partner-training program for families and social networks of people with traumatic brain injury.

Mark Ylvisaker's influence on scripts, videos, and projects within a South African context.

The current article overviews a range of collaborative group projects undertaken by members of the Conversation Groups for individuals living with aphasia and cognitive-communication disorders in the Department of Communication Pathology, University of Pretoria, South Africa. Projects work toward creating networks of support and lessening barriers for the individual living with aphasia and cognitive-communication disorders. The article highlights the pervasive and far-reaching influence across continents of Professor Mark Ylvisaker's philosophy, writings, and personal teachings on both Conversation Group projects as well as student clinician-training practice in the University of Pretoria context. In addition, Ylvisaker's influence is described on the development of a collaborative communication partner-training program within a South African retail supermarket environment, highlighting the effort to remove barriers between employees and customers with a cognitive-communication disability specifically.

Clinical influences.

Mark Ylvisaker influenced a paradigm shift on approaches to assessment and intervention of individuals with a traumatic brain injury (TBI). This article describes the influence of Mark Ylvisaker on my speech-language therapy practice in TBI rehabilitation, from shaping assessment research through supporting a practical, problem-solving approach to intervention. In this article, only a small selection of his therapeutic concepts and recommendations are described. The concepts selected-context and meaningfulness, collaboration, and measuring performance-are those that are pertinent to functional communication assessment. The three interventions chosen illustrate the applicability of Mark Ylvisaker's work in different contexts and across different levels of disability following TBI. They are also selected as they promote personally satisfying communication for the client and illustrate the contribution that speech-language therapy may make to TBI rehabilitation overall.

The early years of language, speech, and hearing services in u.s. Schools.

PURPOSE: This article focuses on various aspects of the beginnings of speech therapy offerings in America's public schools. It traces the pioneering professionals and significant milestones associated with diagnostic and therapy practices during the late 19th and early 20th century. The aim is to uncover the neglected history of public school speech therapy practices and to show how the practices of yesterday compare with those of today. METHOD: Historical documents were analyzed to discover the key contributors and locations of the first public school speech-pathology programs. The analysis also traces the populations that were served and the professional training of the early practitioners, as well as their therapy and service delivery practices. CONCLUSIONS: Between 1895 and 1921, most of the major cities in the United States had hired their first speech clinicians. Between 1921 and 1930, many cities expanded their programs and were hiring supervisors to coordinate these services. These early clinicians carved out some now-familiar practices. Comparing what they did and when and how they did it with today's practices can offer school clinicians of today a sense of their own history and identity. Such an understanding can also provide insights about some of today's taken-for-granted practices.

Evidence-based treatment and stuttering--historical perspective.

PURPOSE: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. METHOD: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking evidence of a different kind: FS seeks evidence concerning treatment outcome, and SM seeks evidence concerning the nature of the stutter event. CONCLUSION: Although outcome evidence provides the principal support for FS, support for SM comes principally from a cognitive learning model of defensive behavior as applied to the nature of the stutter event. Neither approach can claim anything like uniform success with adults who stutter. However, self-management and modeling are strategies common to both approaches and have shown consistently positive effects on outcome. It is argued that both strategies merit additional treatment efficacy study. Cognitive behavior theory may provide a useful framework for this research.